VIVEK KANTAYYA

BOISE, ID
NPI1437132479
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: ID  M-12703)
Additional Taxonomies207Q00000X Family Medicine
(Licence: IL  036081072)
Enumeration Date2005-11-23
Last Update Date2015-06-09
Business Address
Dr. VIVEK KANTAYYA MD
300 S 23RD ST
BOISE, ID 83702-9100
Phone number: 208-344-3512
Mailing Address
Dr. VIVEK KANTAYYA MD
3063 S OLD HICKORY ST
BOISE, ID 83716-5812
Phone number: 815-871-3628